Post-treatment imaging of gliomas: challenging the existing dogmas

Gliomas are the commonest malignant central nervous system tumours in adults and imaging is the cornerstone of diagnosis, treatment, and post-treatment follow-up of these patients. With the ever-evolving treatment strategies post-treatment imaging and interpretation in glioma remains challenging, more so with the advent of anti-angiogenic drugs and immunotherapy, which can significantly alter the appearance in this setting, thus making interpretation of routine imaging findings such as contrast enhancement, oedema, and mass effect difficult to interpret. This review details the various methods of management of glioma including the upcoming novel therapies and their impact on imaging findings, with a comprehensive description of the imaging findings in conventional and advanced imaging techniques. A systematic appraisal for the existing and emerging techniques of imaging in these settings and their clinical application including various response assessment guidelines and artificial intelligence based response assessment will also be discussed.

Ion specific tuning of nanoparticle dispersion in an ionic liquid: a structural, thermoelectric and thermo-diffusive investigation

Dispersions of charged maghemite nanoparticles (NPs) in EAN (ethylammonium nitrate) a reference Ionic Liquid (IL) are studied here using a number of static and dynamical experimental techniques; small angle scattering (SAS) of X-rays and of neutrons, dynamical light scattering and forced Rayleigh scattering. Particular insight is provided regarding the importance of tuning the ionic species present at the NP/IL interface. In this work we compare the effect of Li+, Na+ or Rb+ ions. Here, the nature of these species has a clear influence on the short-range spatial organisation of the ions at the interface and thus on the colloidal stability of the dispersions, governing both the NP/NP and NP/IL interactions, which are both evaluated here. The overall NP/NP interaction is either attractive or repulsive. It is characterised by determining, thanks to the SAS techniques, the second virial coefficient A2, which is found to be independent of temperature. The NP/IL interaction is featured by the dynamical effective charge ξeff0 of the NPs and by their entropy of transfer ŜNP (or equivalently their heat of transport ) determined here thanks to thermoelectric and thermodiffusive measurements. For repulsive systems, an activated process rules the temperature dependence of these two latter quantities.

Imaging of Neck Nodes in Head and Neck Cancers - a Comprehensive Update

Cervical lymph node metastases from head and neck squamous cell cancers significantly reduce disease-free survival and worsen overall prognosis and, hence, deserve more aggressive management and follow-up. As per the eighth edition of the American Joint Committee on Cancer staging manual, extranodal extension, especially in human papillomavirus-negative cancers, has been incorporated in staging as it is important in deciding management and significantly impacts the outcome of head and neck squamous cell cancer. Lymph node imaging with various radiological modalities, including ultrasound, computed tomography and magnetic resonance imaging, has been widely used, not only to demonstrate nodal involvement but also for guided histopathological evaluation and therapeutic intervention. Computed tomography and magnetic resonance imaging, together with positron emission tomography, are used widely for the follow-up of treated patients. Finally, there is an emerging role for artificial intelligence in neck node imaging that has shown promising results, increasing the accuracy of detection of nodal involvement, especially normal-appearing nodes. The aim of this review is to provide a comprehensive overview of the diagnosis and management of involved neck nodes with a focus on sentinel node anatomy, pathogenesis, imaging correlates (including radiogenomics and artificial intelligence) and the role of image-guided interventions.

Simple deformation measures for discrete elastic rods and ribbons

The discrete elastic rod method (Bergou et al. 2008 ACM Trans. Graph . 27 , 63:1–63:12. ( doi:10.1145/1360612.1360662 )) is a numerical method for simulating slender elastic bodies. It works by representing the centreline as a polygonal chain, attaching two perpendicular directors to each segment and defining discrete stretching, bending and twisting deformation measures and a discrete strain energy. Here, we investigate an alternative formulation of this model based on a simpler definition of the discrete deformation measures. Both formulations are equally consistent with the continuous rod model. Simple formulae for the first and second gradients of the discrete deformation measures are derived, making it easy to calculate the Hessian of the discrete strain energy. A few numerical illustrations are given. The approach is also extended to inextensible ribbons described by the Wunderlich model, and both the developability constraint and the dependence of the energy on the strain gradients are handled naturally.

Fracture Diodes: Directional Asymmetry of Fracture Toughness

Toughness describes the ability of a material to resist fracture or crack propagation. It is demonstrated here that fracture toughness of a material can be asymmetric, i.e., the resistance of a medium to a crack propagating from right to left can be significantly different from that to a crack propagating from left to right. Such asymmetry is unknown in natural materials, but we show that it can be built into artificial materials through the proper control of microstructure. This paves the way for control of crack paths and direction, where fracture-when unavoidable-can be guided through predesigned paths to minimize loss of critical components.

First Measurement of Inclusive Muon Neutrino Charged Current Differential Cross Sections on Argon at E_{ν}∼0.8 GeV with the MicroBooNE Detector

We report the first measurement of the double-differential and total muon neutrino charged current inclusive cross sections on argon at a mean neutrino energy of 0.8 GeV. Data were collected using the MicroBooNE liquid argon time projection chamber located in the Fermilab Booster neutrino beam and correspond to 1.6×10^{20} protons on target of exposure. The measured differential cross sections are presented as a function of muon momentum, using multiple Coulomb scattering as a momentum measurement technique, and the muon angle with respect to the beam direction. We compare the measured cross sections to multiple neutrino event generators and find better agreement with those containing more complete treatment of quasielastic scattering processes at low Q^{2}. The total flux integrated cross section is measured to be 0.693±0.010(stat)±0.165(syst)×10^{-38}  cm^{2}.

Effectiveness of Early Hematopoietic Stem Cell Transplantation in Preventing Neurocognitive Decline in Mucopolysaccharidosis Type II: A Case Series

The early progressive form of the X-linked disorder, Hunter syndrome or mucopolysaccharidosis type II (MPS II) (OMIM #309900), is characterized by cognitive decline, and pulmonary and cardiac complications that often cause death before 20 years of age. Deficiency of the lysosomal enzyme, iduronate-2-sulfatase (EC 3.1.6.13) results in deposition of the glycosaminoglycans, dermatan, and heparan sulfate in various tissues. In recent years, enzyme replacement therapy (ERT) has become the mainstay of treatment, but is expensive and ineffective in arresting cognitive decline. Hematopoietic stem cell transplantation (HSCT) also provides enzyme replacement, and may be effective in stabilizing neurocognitive function if initiated early, though data are limited. We present a case series of four patients who demonstrated neurocognitive stabilization with early HSCT. HSCT is a potentially underutilized treatment strategy for select groups of MPS II patients.

Involvement of NK Cells against Tumors and Parasites

Host resistance against pathogens depends on a complex interplay of innate and adaptive immune mechanisms. Acting as an early line of defence, the immune system includes activation of neutrophils, tissue macrophages, monocytes, dendritic cells, eosinophils and natural killer (NK) cells. NK cells are lymphoid cells that can be activated without previous stimulation and are therefore like macrophages in the first line of defence against tumor cells and a diverse range of pathogens. NK cells mediate significant activity and produce high levels of proinflammatory cytokines in response to infection. Their cytotoxicity production is induced principally by monocyte-, macrophage- and dendritic cell-derived cytokines, but their activation is also believed to be cytokine-mediated. Recognition of infection by NK cells is accomplished by numerous activating and inhibitory receptors on the NK cells’ surface that selectively trigger the cytolytic activity in a major histocompability complex-independent manner. NK cells have trypanocidal activity of fibroblast cells and mediate direct destruction of extracellular epimastigote and trypomastigote forms of T. cruzi and T. lewisi in vitro; moreover, they kill plasmodia-infected erythrocytes directly through cell-cell interaction. This review provides a more detailed analysis of how NK cells recognize and respond to parasites and how they mediate cytotoxicity against tumor cells. Also the unique role of NK cells in innate immunity to infection and the relationship between parasites and carcinogenesis are discussed.

Refractive index profilometry using the total internally reflected light field

A full-field polarization-based technique is presented for quantitative evaluation of the spatial distribution of the refractive index in macro and micro samples. The sample is mounted on a glass-air interface of a prism, illuminated by a linearly polarized collimated light beam, and two intensity frames are digitally recorded with specific orientations of an analyzer. The pair of intensity data frames captured with this simple setup is combined through an algorithm specially developed for the purpose, to yield the phase difference between the transverse electric and transverse magnetic components of the total internally reflected light field. The phase difference is then related to the refractive index of the sample. Experimental results for refractive index variations in a laser-etched glass plate and red blood corpuscles are presented. One of the salient features of the proposed technique is that the depth of measurement is dependent on the penetration depth of the sample's evanescent field, which is typically of the order of a few hundred nanometers, thereby facilitating refractive index measurements along a thin section of the sample.

Safe limit of arsenic in soil in relation to dietary exposure of arsenicosis patients from Malda district, West Bengal- A case study

Safe limit of arsenic in soil in relation to dietary exposure of arsenicosis patients was established in Malda district of West Bengal. Out of 182 participants examined, 80 (43.9%) participants showed clinical features of arsenicosis, characterized by arsenical skin lesion (pigmentation and keratosis), while 102 participants did not have any such lesion (control). Experimental results of the twenty eight soils (own field) of the participants showed the mean Olsen extractable and total arsenic concentration of 0.206 and 6.70mgkg^-1, respectively. Arsenic concentration in rice grain ranged from 2.00 to 1260μgkg^-1 with the mean value of 146μgkg^-1. The hazard quotient (HQ) for intake of As by human through consumption of rice varied from 0.03 to 3.52. HQ exceeds 1.0 for drinking water and rice grain grown in the study area in many cases. As high as 77.6% variation in As content in rice grain could be explained by the solubility-free ion activity model. Toxic limit of extractable As in soil for rice in relation to soil properties and human health hazard, associated with consumption of rice grain by human, was established. For example, the permissible limit of Olsen extractable As in soil would be 0.43mgkg^-1 for rice cultivation, if soil pH and organic carbon content were 7.5% and 0.50%, respectively. However, the critical limit of Olsen extractable As in soil would be 0.54mgkg^-1, if soil pH and organic carbon were 8.5% and 0.75%, respectively. The conceptual framework of fixing the toxic limit of arsenic in soils with respect to soil properties and human health under modeling-framework was established.

Low-level birefringence measurement by cyclic-path polarization interferometer

A modified cyclic-path interferometer is employed for complete measurement of spatially varying birefringence. An expanded and collimated laser beam intercepted by a birefringent specimen is incident on a polarization-masked cube beam splitter, resulting in two mutually orthogonal polarization components propagating along clockwise and counterclockwise directions in the interferometer. These two wavefronts are made to interfere for four specific orientations of an analyzer. Suitable combinations of the interferograms result in determination of the direction of birefringence and its magnitude. Experimental results are presented.

PTEN negatively regulates mTORC2 formation and signaling in grade IV glioma via Rictor hyperphosphorylation at Thr1135 and direct the mode of action of an mTORC1/2 inhibitor

To investigate the role of PTEN (phosphatase and tensin homolog) in mammalian target of rapamycin complex 2 (mTORC2) signaling in glioblastoma multiforme (GBM), we found higher activation of mTORC2 in PTEN(mu) cells, as evidenced by enhanced phosphorylation of mTOR (Ser2481), AKT (Ser473) and glycogen synthase kinase 3 beta (GSK3β) (Ser9) as compared with PTEN(wt) cells. In addition, PTEN(wt) cells upon PTEN depletion showed mTORC2 activation. The reduced mTORC2 signaling in PTEN(wt) cells was related to higher Rictor phosphorylation at Thr1135 residue. Phosphorylation of Rictor at Thr1135 inhibited its association with mTORC and thus there was a reduction in mTORC2 complex formation. In addition, PTEN(wt) cells expressing mutated Rictor in which Thr1135 was substituted with alanine, showed enhanced mTORC2 formation and signaling. This enhanced mTORC2 signaling promoted inactivation of GSK3β. Thus, we established the reciprocal activation of mTORC2 and GSK3β in GBM. To the best of our knowledge, this is the first report describing role of PTEN in mTORC2 formation by promoting Rictor phosphorylation (Thr1135) in GBM. Furthermore, the drug sensitivity of mTORC2 was evaluated. A newly identified carbazole alkaloid, mahanine, showed cytotoxicity in both PTEN(mu) and PTEN(wt) cells. It inhibited both mTORC1/2 and AKT completely in PTEN(mu) cells, whereas it inhibited only mTORC1 in PTEN(wt) cells. Cytotoxity and AKT-inhibitory activity of the mTORC1/2 inhibitor was increased either by depleting PTEN or in combination with phosphatidylinositol 3 kinase inhibitors in PTEN(wt) cells. In contrast, depletion of Rictor decreased the cytotoxicity of the mTORC1/2 inhibitor in PTEN(mu) cells. Thus, PTEN has an important role in mTORC2 formation and also influences the effectiveness of an mTORC1/2 inhibitor in GBM.

Identification of different species of Bacillus isolated from Nisargruna Biogas Plant by FTIR, UV-Vis and NIR spectroscopy

Definitive identification of microorganisms, including pathogenic and non-pathogenic bacteria, is extremely important for a wide variety of applications including food safety, environmental studies, bio-terrorism threats, microbial forensics, criminal investigations and above all disease diagnosis. Although extremely powerful techniques such as those based on PCR and microarrays exist, they require sophisticated laboratory facilities along with elaborate sample preparation by trained researchers. Among different spectroscopic techniques, FTIR was used in the 1980s and 90s for bacterial identification. In the present study five species of Bacillus were isolated from the aerobic predigester chamber of Nisargruna Biogas Plant (NBP) and were identified to the species level by biochemical and molecular biological (16S ribosomal DNA sequence) methods. Those organisms were further checked by solid state spectroscopic absorbance measurements using a wide range of electromagnetic radiation (wavelength 200 nm to 25,000 nm) encompassing UV, visible, near Infrared and Infrared regions. UV-Vis and NIR spectroscopy was performed on dried bacterial cell suspension on silicon wafer in specular mode while FTIR was performed on KBr pellets containing the bacterial cells. Consistent and reproducible species specific spectra were obtained and sensitivity up to a level of 1000 cells was observed in FTIR with a DTGS detector. This clearly shows the potential of solid state spectroscopic techniques for simple, easy to implement, reliable and sensitive detection of bacteria from environmental samples.

Should an increase in cerebral neurochemicals following head kicks in full contact karate influence return to play?

Background:

Cerebral neurochemicals are markers of traumatic brain injury (TBI).

Objectives:

The aim of the study was to determine whether kicks to the head (KTH) in full contact karate significantly increased serum concentrations of protein S-100B, and neurone specific enolase (NSE). Kicks to the body (KTB) were also quantified to asses muscle tissue injury. Muscle damage was assessed by analysis of serum total creatine kinase (CK).

Methods:

Twenty-four full contact karate practitioners were observed and filmed during actual competition and divided into two main groups post event: (1) Kicks to the head and body group (KTH): n = 12; mean ± SD; age, 30.4 ± 6.7 years; height, 1.74 ± 0.1 m; weight, 79.1 ± 2.1 kg; and (2): Kicks to the body group (KTB): n = 12; mean ± SD; age, 28.2 ± 6.5 years; height, 1.75 ± 0.1 m; weight, 79.2 ± 1.7 kg. The KTH group received direct kicks to the head, while group KTB received kicks and punches to the body. Blood samples were taken before and immediately post-combat for analysis of serum S-100B, NSE, CK and cardiac troponin.

Results:

Significant increases in serum concentrations of S-100B (0.12 ± 0.17 vs. 0.37 ± 0.26, µg.L−1) and NSE (11.8 ± 4.1 vs. 20.2 ± 9.1 ng.mL−1) were encountered after combat in the KTH group and CK (123 ± 53 vs. 184 ± 103 U.L−1) in the KTB group (all P <0.05).

Conclusions:

Head kicks in full contact karate cause elevation of neurochemical markers associated with damaged brain tissue. The severity of injury is related to the early post-traumatic release of protein S-100B and NSE. The early kinetics and appearance post injury can reflect intracranial pathology, and suggest S-100B and NSE are extremely sensitive prognostic markers of TBI.

Hybrid nanostructured C-dot decorated Fe3O4electrode materials for superior electrochemical energy storage performance

Here, the novel Fe₃O₄-C hybrid nanocomposite demonstrates high specific capacitance (S.C.) than the pristine Fe₃O₄nanospheres due to the presence of the highly conducting carbon quantum dots.

Pentoxifylline Plus Prednisolone versus Pentoxifylline Only for Severe Alcoholic Hepatitis: A Randomized Controlled Clinical Trial

Background:

Prednisolone and pentoxifylline (PTX) have been shown to be individually useful in severe alcoholic hepatitis with Maddrey discriminant function (MDF) score ≥32. Previous report suggests that PTX is probably superior to prednisolone alone. However the efficacy of PTX and prednisolone combination over PTX alone in the management of acute alcoholic hepatitis (MDF score ≥32) is yet unrevealed.

Aim:

The present study was initiated to find out the efficacy of combined pentoxifylline and prednisolone versus PTX alone in acute alcoholic hepatitis in respect of short and intermediate term outcomes.

Subjects and Methods:

A total of 124 patients with severe alcoholic hepatitis (MDF score ≥ 32) initially were evaluated. 62 patients who fulfilled the inclusion and exclusion criteria were randomized and divided into 2 groups. Group 1 received PTX only, whereas Group 2 received PTX plus Prednisolone. The total duration of follow-up was 12 months. Student's t-test, Chi-square test, the Kaplan-Meier methods were used for statistical analysis.

Results:

A total of 60 patients, 30 in each group were available for final analysis. In Group-1, 6 patients expired at the end of 1 year (5 within 3 months and another after 3 months). In Group 2, 10 patients expired at the end of 1 year (9 within 3 months and another after 3 months). Though survival probability is higher among Group 1 patients but the difference is not statistically significant.

Conclusion:

The combination of PTX plus Prednisolone yields no additional benefit in terms of mortality and morbidity from that of PTX monotherapy.

Microscopy of non-birefringent transmissive phase samples using Sagnac laser interferometer

A cyclic interferometer, appropriately combined with a long working distance microscope objective, is adapted for quantitative phase microscopy. In such an arrangement, the sample information, in terms of the diffracted orders emerging from the sample, is carried by both the counter propagating beams within the cyclic interferometer. However, positioning the sample close to the input/output cube beam splitter and use of a suitably converging laser beam of light as the input to the interferometer ensure that only one of the counter propagating beams carries the object information to the objective while the other beam, which serves as the reference, allows only the undiffracted component to contribute to the process of image formation. Use of suitable polarization optics renders the interferometer its polarization phase shifting property. Using the proposed arrangement, the experimental results showing the quantitative 3D phase rendering of polystyrene microspheres and micro-wells etched in glass are presented.

Multiscale instabilities in soft heterogeneous dielectric elastomers

The development of instabilities in soft heterogeneous dielectric elastomers is investigated. Motivated by experiments and possible applications, we use in our analysis the physically relevant referential electric field instead of electric displacement. In terms of this variable, a closed form solution is derived for the class of layered neo-Hookean dielectrics. A criterion for the onset of electromechanical multiscale instabilities for the layered composites with anisotropic phases is formulated. A general condition for the onset of the macroscopic instability in soft multiphase dielectrics is introduced. In the example of the layered dielectrics, the essential influence of the microstructure on the onset of instabilities is revealed. We found that: (i) macroscopic instabilities dominate at moderate volume fractions of the stiffer phase, (ii) interface instabilities appear at small volume fractions of the stiffer phase and (iii) instabilities of a finite scale, comparable to the microstructure size, occur at large volume fractions of the stiffer phase. The latest new type of instabilities does not appear in the purely mechanical case and dominates in the region of large volume fractions of the stiff phase.

Real-time edge detection by cyclic-path polarization interferometer

In a triangular path cyclic interferometer employing a polarizing beam splitter (PBS), the two counterpropagating beams are orthogonally polarized. A sample placed almost equidistant from the PBS is imaged by a lens placed in the path of the emerging beams so that two defocused images of the sample are recorded on a CCD. Using a linear polarizer in the path of the orthogonally polarized imaging beams, it is possible to achieve amplitude subtraction between the two images, resulting in an edge-enhanced image of the sample. The proposed real-time edge-enhancement technique is experimentally demonstrated.

Screening obesity by direct and derived anthropometric indices with evaluation of physical efficiency among female college students of kolkata

BACKGROUND

The available information regarding the obesity pattern of the undergraduate female students of Kolkata is inadequate, though there are several reports which indicate the complications and/or awful consequences of obesity on female health particularly, during the reproductive years.

AIM

The present investigation has thus been carried out to report their present physiological status along with the prevalence of obesity, based on their body mass index (BMI), some direct and derived anthropometric indices, and physical fitness.

SUBJECTS AND METHODS

This small-scale cross-sectional study conducted in randomly selected 100 female students of different colleges of Kolkata with the age of 18-22 [mean age 20.4 (2.3)] years. Measurements of body composition included total 24 variables, with thirteen direct and eleven derived anthropometric variables; while physical efficiency parameters were physical fitness index, VO2max, energy expenditure and anaerobic power. The data of the experimental group were compared with those of the control group by t-test, using SPSS v.15.0 and MS-Excel v.2013.

RESULTS

Analysis of collected data showed majority of the students have normal range of BMI (67.95%), but, 21.95% of students found to be overweight and 3.84% are obese. They also showed higher fat mass [14.40 (4.11)], but, lower waist-to-hip ratio and conicity index. They were found to have poor to moderate physical fitness [57.60 (3.90)] and higher energy expenditure [5.61 (0.72)].

CONCLUSION

The findings of the present obesity screening reports almost one of four female students (24 out of 100 participants) are overweight/obese, indicated higher body fat distribution and increased propensity of being obese with age. Thus, the overall data along with their low physical fitness points out to health risks among female undergraduates of Kolkata.

Toughening and asymmetry in peeling of heterogeneous adhesives

The effective adhesive properties of heterogeneous thin films are characterized through a combined experimental and theoretical investigation. By bridging scales, we show how variations of elastic or adhesive properties at the microscale can significantly affect the effective peeling behavior of the adhesive at the macroscale. Our study reveals three elementary mechanisms in heterogeneous systems involving front propagation: (i) patterning the elastic bending stiffness of the film produces fluctuations of the driving force resulting in dramatically enhanced resistance to peeling; (ii) optimized arrangements of pinning sites with large adhesion energy are shown to control the effective system resistance, allowing the design of highly anisotropic and asymmetric adhesives; (iii) heterogeneities of both types result in front motion instabilities producing sudden energy releases that increase the overall adhesion energy. These findings open potentially new avenues for the design of thin films with improved adhesion properties, and motivate new investigations of other phenomena involving front propagation.

Self-referenced rectangular path cyclic interferometer with polarization phase shifting

A polarization phase shifting interferometer using a cyclic path configuration for measurement of phase nonuniformities in transparent samples is presented. A cube beam splitter masked by two linear polarizers is used to split the source wavefront into two counter propagating linearly polarized beams that pass through the sample. At the output of the interferometer, the two orthogonally polarized beams are rendered circularly polarized in the opposite sense through the use of a quarter wave plate. Finally, phase shifting is achieved by rotating a linear polarizer before the recording plane. In a rectangular path interferometer, although the two counter propagating wavefronts are laterally folded with respect to each other in the interferometer arms, the beams finally emerge mutually unfolded at the output of the interferometer. This phenomenon is utilized to create a reference if the sample is introduced in one lateral half of the beam in any one of the interferometer arms. The polarization phase shifting technique is used to generate four phase-shifted interferograms, which are utilized to evaluate the phase profile of the phase sample. Experimental results presented validate the proposed technique.

A study on evalution of antidepressant effect of imipramine adjunct with Aswagandha and Bramhi

Depressive disorders increase the risks of self-harm or even suicide in patients. Indigenous drugs are being tried to treat such patient along with conventional antidepressant drugs. This study was planned to investigate the antidepressant action of Ashwagandha and Bramhi and also to confirm its efficacy in the behavioural despair animal model of depression. Normal saline as control (5 ml/kg), Imipramine as standard (16, 32, 64 mg/ kg) and Ashwagandha (50, 100, 150 mg/kg), Bramhi (20, 40, 80 mg/kg) as test drugs were introduced to the albino rats weighing between 200-250 gm for 2 weeks, 1 hr before electric shock in Learned helplessness test (LHT) and swimming in Forced swimming test (FST). Effects of individual drugs as well as their combination were evaluated. Avoidance response, escape failure and immobility period in case of Imipramine and Ashwagandha showed highly significant (p < 0.01) result on individual use. There was no significant result in case of Bramhi used alone except in escape failure and immobility period (FST), where at higher doses it showed significant (p < 0.01) result. But combination of Bramhi and Ashwagandha in low doses with low dose of Imipramine gave a highly significant result (p < 0.01) in all the parameters. Ashwagandha had significant antidepressant action, but Bramhi had not when used alone. Combination of these two indigenous drug with Imipramine showed high efficacy in animal model.

Kurt Semm: A laparoscopic crusader

A brief biography of Kurt Semm, the pioneer of laparoscopic appendectomy and inventor of various laparoscopic instruments are done, with special reference to his struggle to establish the foundation of minimally invasive surgery amongst his contemporary surgeons.

A Theory of Shape-Memory Thin Films with Applications

Shape-memory alloys have the largest energy output per unit volume per cycle of known actuator systems [1]. Unfortunately, they are temperature activated and hence, their frequency is limited in bulk specimens. However, this is overcome in thin films; and hence shape-memory alloys are ideal actuator materials in micromachines[l]. The heart of the shape-memory effect lies in a martensitic phase transformation and the resulting microstructure. It is well-known that microstructure can be significantly different in thin films as compared to bulk materials. In this paper, we report on a theory of single crystal martensitic this films. We show that single crystal films of shape memory material offer interesting possibilities for producing very large deformations, at small scales.

Direct Hits to the Head during Amateur Boxing is Associated with a Rise in Serum Biomarkers for Brain Injury

Boxing exposes participants to the physiological response to high intensity exercise and also to direct body and brain trauma. Amateur boxing is increasing and females have also been included in the Olympics. The aim of this study is to assess the stress response and possible brain injury incurred during a match by measuring serum biomarkers associated with stress and cellular brain injury before and after combat. Sixteen male amateur boxers were studied retrospectively. The study population was divided into two groups: (a) a group that received predominantly punches to the head (PTH) and (b) a group that received predominantly punches to the body (PTB). Blood samples were taken before and five minutes after each contest. They were analysed for S-100B, neuron-specific enolase (NSE), creatine kinase (CK) and cortisol. The PTH group received direct contacts to the head (not blocked, parried or avoided) and to the body ( n=8, age: 17.6 ± 5.3, years; height: 1.68 ± 0.13, meters; mass: 65.4 ± 20.3, kg). The PTB group received punches to the body including blocked and parried punches, but received no direct punches to the head, ( n=8, mean ± SD, age: 19.1 ± 3.2 years; height: 1.70 ± 0.75, meters; mass: 68.5 ± 15 kg). Significant increases ( P<0.05) were observed between pre- and post-combat serum concentrations in serum concentrations in PTH of S-100B (0.35 ± 0.61 vs. 0.54 ± 0.73, μg.L−1) NSE (19.7 ± 14 vs.31.1 ± 26.6, ng.ml−1) and cortisol (373 ± 202 vs. 756± 93, nmol.L−1). Significant increases ( P<0.05) of creatine kinase were recorded in both groups. This study demonstrates significant elevations in neurochemical biomarkers in boxers who received direct blows to the head. However, further work is required to quantify this volumetric brain damage and long term clinical sequelae.

Gaussian curvature from flat elastica sheets

We discuss methods of reversibly inducing non-developable surfaces from flat sheets of material at the micro-scale all the way to macroscopic objects. We analyse the elastic ground states of a nematic glass in the membrane approximation as a function of temperature for disclination defects of topological charge +1. An aim is to show that by writing an appropriate director field into such a solid, one could create a surface with Gaussian curvature, dynamically switchable from flat sheets while avoiding stretch energy. In addition to the prospect of programmable structures, such surfaces offer actuation via stretch in thin systems since when illumination is subsequently removed, unavoidable stretches return.

Congenital disorder of glycosylation type Ia: heterogeneity in the clinical presentation from multivisceral failure to hyperinsulinaemic hypoglycaemia as leading symptoms in three infants with phosphomannomutase deficiency

We describe three patients with congenital disorder of glycosylation (CDG) type Ia, all of whom had persistent hyperinsulinaemic hypoglycaemia responding to diazoxide therapy as a common feature. The first patient, an infant girl, presented with recurrent vomiting, failure to thrive, liver impairment, hypothyroidism and a pericardial effusion. The second patient, also female, had a milder disease with single organ involvement, presenting as isolated hyperinsulinaemic hypoglycaemia, not associated with any cognitive impairment. The third patient, a boy presented with multi-organ manifestations including congenital hypothyroidism, persistent hyperinsulinaemic hypoglycaemia, coagulopathy, olivopontocerebellar hypoplasia and recurrent pancreatitis. All three patients had a type 1 serum transferrin isoform pattern, and were subsequently found to have low phosphomannomutase activity, confirming the diagnosis of CDG type Ia. Our findings emphasize that CDG should be considered as a differential diagnosis in patients with persistent hyperinsulinaemic hypoglycaemia and that it may even occasionally be the leading symptom in CDG Ia.

Supersoft elasticity in polydomain nematic elastomers

We consider the equilibrium stress-strain behavior of polydomain liquid crystal elastomers (PLCEs). We show that there is a fundamental difference between PLCEs cross-linked in the high temperature isotropic and low temperature aligned states. PLCEs cross-linked in the isotropic state then cooled to an aligned state will exhibit extremely soft elasticity (confirmed by recent experiments) and ordered director patterns characteristic of textured deformations. PLCEs cross-linked in the aligned state will be mechanically much harder and characterized by disclination textures.

Characterization of soft stripe-domain deformations in Sm-C and Sm-C* liquid-crystal elastomers

The neoclassical model of Sm-C (and Sm-C*) elastomers developed by Warner and Adams predicts a class of "soft" (zero energy) deformations. We find and describe the full set of stripe domains-laminate structures in which the laminates alternate between two different deformations-that can form between pairs of these soft deformations. All the stripe domains fall into two classes, one in which the smectic layers are not bent at the interfaces, but for which--in the Sm-C* case--the interfaces are charged, and one in which the smectic layers are bent but the interfaces are never charged. Striped deformations significantly enhance the softness of the macroscopic elastic response.

Open access colonoscopy in the training setting: which factors affect patient satisfaction and pain?

BACKGROUND AND STUDY AIM

Patient satisfaction with colonoscopy is important for quality assurance; it may be affected by various factors, including patient characteristics, physician training level, and procedural or organizational features. We aimed to analyze how these factors influenced patient satisfaction and pain in an outpatient training setting.

METHODS

Consecutive patients for open access colonoscopy (OAC) were enrolled in a prospective, single-blinded, controlled study. Primary and secondary outcomes were satisfaction and pain scores with and without trainee participation. A multivariate analysis was designed to achieve an 80 % power with an alpha value of 0.05.

RESULTS

368 patients were enrolled. Satisfaction with the procedure was high (mean score 1.36; 1 = best to 5 = worst). In the multivariate analysis only waiting time in the endoscopy suite was significantly associated with lower satisfaction scores ( P = 0.024). Satisfaction was unaffected by patient factors (gender, American Society of Anesthesiologists' [ASA] score, anxiety, etc). Higher pain scores were associated with higher anxiety levels ( P = 0.02), female gender ( P = 0.02), longer procedure ( P< 0.001), and lower sedation levels ( P = 0.001); trainee involvement (49 % of procedures) did not adversely affect satisfaction or pain scores.

CONCLUSIONS

Patient satisfaction with OAC using sedation appears to depend primarily on organizational factors (waiting time beforehand). In contrast, pain is associated with patient characteristics (female gender, anxiety) and procedural factors (lower sedation, longer procedure). Trainee participation did not affect satisfaction or pain scores, a finding which may help to reassure patients undergoing OAC with trainee participation.

Vanadium pentoxide-coated ultrafine titanium dioxide particles induce cellular damage and micronucleus formation in V79 cells

Surface-treated titanium dioxide (TiO(2)) particles coated with vanadium pentoxide (V(2)O(5)) are used industrially for selective catalytic reactions such as the removal of nitrous oxide from exhaust gases of combustion power plants (SCR process) and in biomaterials for increasing the strength of implants. In the present study, untreated ultrafine TiO(2) particles (anatase, diameter: 30-50 nm) and vanadium pentoxide (V(2)O(5))-treated anatase particles were tested for their cyto- and genotoxic effects in V79 cells (hamster lung fibroblasts). Cytotoxic effects of the particles were assessed by trypan blue exclusion, while genotoxic effects were investigated by micronucleus (MN) assay. In addition, the generation of reactive oxygen species (ROS) was determined by the acellular method of electron spin resonance technique (ESR) and by the cellular technique of determination of thiobarbituric acid-reactive substances (TBARS). Our results demonstrate that V(2)O(5)-treated TiO(2) particles induce more potent cyto- and genotoxic effects than untreated particles. Further, acellular and cellular radical formation was more pronounced with V(2)O(5)-anatase than untreated anatase. Thus, data indicate that V(2)O(5)-treated TiO(2) particles were more reactive than natural anatase and capable of inducing DNA damage in mammalian cells through production of free radicals.

Anti-chemokine therapy for inflammatory diseases

Chemokines are inflammatory proteins acting via G-protein coupled chemokine receptors that trigger different signaling pathways. Monocyte chemoattractant protein-1 (CCL2/MCP-1) and regulated on activation, normal T expressed and secreted (CCL5/RANTES) are the two major members of the CC chemokine beta subfamily. The roles of RANTES and MCP-1 are emerging in regulating the recruitment of inflammatory cells into tissue during inflammation. The inhibition of MCP-1 and RANTES with corresponding antibodies or other inhibitors may provide benefits in different clinical scenarios including cancer, inflammation, CNS disorders, parasitic disease, autoimmune and heart diseases. RANTES and MCP-1 may represent targets for diagnostic procedures and therapeutic intervention, and may be useful as a prognostic factor in the above diseases.

Recurrent total hip arthroplasty dislocation in combination with massive osteolysis: an outline of management using a proximal femoral replacement

Recurrent dislocation of a total hip arthroplasty is a most distressing complication for both patient and surgeon. The situation is worsened when massive osteolysis occurs in combination with recurrent dislocation. Management options become more limited in this situation. We present such a case along with a discussion of the management options utilised.